Dear Doctors: I come from a large family, and we’ll have a lot of holiday parties. I want to enjoy myself, but I also want to start the new year feeling healthy. My concern is more about drinking alcohol than about eating. I would appreciate it if you could talk about how to handle that part of the holidays.

Dear Reader: When people think about how to manage the numerous excesses of this time of year, the focus is often on the abundance of rich food. Whether it’s at home, the office or social gatherings, we’re actively encouraged to overindulge. And this turns out to be true not just for those tempting platters of cookies, cakes and other sweet and savory treats, but for alcohol consumption as well.

Surveys into the question suggest that in the weeks between Thanksgiving and the new year, alcohol consumption spikes. For some people, it’s as much as double what they drink during the rest of the year. With eggnog, adult ciders, spiked punch and celebratory glasses of sparkling wine, it’s not that hard for extra alcohol to creep into one’s daily life.

Even a short-term increase in alcohol use can have adverse health effects, including changes in blood sugar control and blood pressure. It can also lead to changes to mood and mental health, lowered resistance to risky behaviors, increased risk of trips or falls and dangerous driving. Statistics show that during the winter holidays, the chances of being involved in an alcohol-related crash increase. All of which is to say that your concerns about holiday drinking are well-founded.

Begin by crafting a plan. Set a drinking limit for yourself before each event -- and stick to it. This can absolutely include the decision to not drink any alcohol at all. If you are going to partake, never do so on an empty stomach. Have a meal, or at least a snack, before heading into the festivities. Once inside, make the food table your first stop, and stick to the protein and vegetable side of things. Protein and fiber both help stabilize blood sugar and keep you feeling full. When you do drink, stay aware of portion size. If you’re planning on more than a single glass of wine or punch or nog, slow down the pace with a nonalcoholic drink (or two) before you refill.

Peer pressure is a real thing when it comes to drinking. Get your nonalcoholic drink served in a wine glass or a flute, and you can head off uncomfortable conversations. Set a time at which you will stop drinking and, again, stick to it. Offers of more alcohol may come your way, so it’s also a good idea to prepare a gracious or funny way to refuse.

For people like yourself, with large families and numerous gatherings to attend, the holidays can be daunting. It helps to visualize this period as a marathon. By preparing yourself in advance, visualizing and even practicing your behaviors, you’ll be much better equipped to navigate the amped-up social drinking landscape.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: It seems like every new health discovery is connected to the gut microbiome these days. I’m 68 years old, and this is new to me. I understand about probiotics, and I even take one, but now I’m seeing ads for prebiotics and postbiotics. What are they? Do I need to take them?

Dear Reader: When it comes to the gut microbiome, we’re all on a learning curve, no matter our age.

Targeted study of our microbial companions dates back to the 17th century, but it’s the recent leaps forward in genomic sequencing technology that have made present-day discoveries possible. Emerging research continues to show that the composition, diversity and behaviors of the trillions of bacteria, fungi, yeasts, viruses and other microbes that colonize our bodies play a pivotal role in human health and well-being.

We agree with you that we’re hearing about new breakthroughs at what feels like a dizzying pace. In the last few years alone, reputable studies have linked the gut microbiome to blood sugar control, Type 1 diabetes, a variety of neurodegenerative diseases, some chronic gastrointestinal disorders, immunity and immune disorders, mood, depression and mental health. These findings have ignited intense interest in the gut and its microscopic residents.

They have also spurred the emergence of a vast and somewhat chaotic marketplace of products -- and a new vocabulary to go with them. This includes terms like “probiotics,” as well as the “prebiotics” and “postbiotics” that you’re asking about. At the root of these new terms is the word “biotics,” which refers to the living components of an ecosystem. In this instance, the living components are the colonies of intestinal microflora, and their ecosystem is the gut.

The word probiotic was coined in 1965. At that time, it described a substance that is produced by one organism and benefits another organism. Today, probiotics refers to the intestinal flora themselves. Someone takes probiotics in an effort to introduce certain species of beneficial microbes into their gut. This can be via supplements or by eating certain foods in which bacteria and other microflora naturally occur.

The trillions of microorganisms in the gut need something to eat, and that’s where prebiotics come into play. The word prebiotics refers to those components of food that, because they are not digestible, reach the large intestine intact. There, they act as food for the microflora of the gut.

Most recently, the word postbiotics has entered the gut microbiome conversation. This refers to the waste products that result from the digestion of prebiotics and probiotics. They include nutrients such as vitamin K and certain B vitamins, and also short chains of proteins that can help control the growth of potentially harmful bacteria.

Retail shelves are stocked with supplements in each of these categories. But whether or not they’re helpful remains unclear. What we do know is that our gut microbiomes are primarily shaped by what we eat. The best way to maintain yours is with a diet that includes naturally fermented foods, a wide range of fresh fruit and vegetables, grains and legumes, and limits added sugars and processed foods.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I’m having hand surgery next year to help with carpal tunnel, and I’m not thrilled about having anesthesia. I’ve been reading about surgeons whose patients use virtual reality headsets to need less anesthesia. Does that really work?

Dear Reader: The use of anesthesia during surgical procedures dates back to antiquity. The historical record shows that the Incas used extracts of plants like datura and coca to reduce pain and induce unconsciousness, and early Chinese physicians offered patients opium-laced potions. Centuries later, efforts to refine and improve the process continue. And small wonder.

Anesthesia is a complex practice with multiple, and sometimes conflicting, objectives. The treatment must sedate the patient and suppress their pain response but not interfere with the body’s critical physiological functions, including heartbeat, breathing and maintaining steady blood pressure. While modern anesthesia is safer than ever before, it still carries an element of risk. That’s why research into novel drugs and new techniques continues.

For the past several years, that research has included inquiries into the use of virtual reality, or VR, as an add-on therapy. This approach is being explored in conjunction with what is known as regional anesthesia. Unlike general anesthesia, where the patient is completely unconscious, someone undergoing regional anesthesia is sedated, but remains conscious. Nerve blocks are used to inhibit sensation from a specific and limited part of the body. The technique is often used in surgery on an extremity, such as an arm, hand, leg or foot.

Because the patient remains awake during regional anesthesia, managing their stress and anxiety is crucial. Many patients receive sedation so they can relax or even doze off during the procedure. With the advent of computer-generated virtual reality, which uses special headsets to plunge the user into an immersive 3D world, researchers began to wonder if it might lessen a surgical patient’s need for sedation.

The most recent study into this idea yielded intriguing results. Over the course of eight months, researchers at a medical center in Boston evaluated the anesthesia needs of 34 patients who were undergoing hand surgery. The patients were divided into two groups. All received drugs to completely block pain response, and all received intravenous sedation. But one group was also given VR headsets with a selection of programs specially designed to promote relaxation and a sense of calm. These included nature scenes, such as a secluded meadow or mountaintop, guided meditations or immersive visuals, such as a starry night sky.

At the end of the study, the data showed that the patients who used VR headsets during their surgery needed markedly less sedation than did the VR-free control group. Additionally, the post-surgical recovery period for the VR group, during which patients wait for the effects of sedation to wear off, was significantly shorter.

While the research is promising, it’s important to note that the surgical teams and the patients understood that VR might lessen the need for sedation, and this could have influenced the outcomes. In your own case, it’s crucial that you discuss your concerns about anesthesia with your surgeon. Understanding the process, the risks and the benefits can help allay your concerns.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)